Strengthening food security policy and practice: can systems approaches improve surveillance data?

Abstract

Background: Household food insecurity is commonly used as a surveillance indicator to inform policy and practice in Canada. However, this indicator does not capture the complex array of social (e.g., housing, education, income) and structural (e.g., climate change, globalization, conflict) causes of food security, which ultimately limits the scope and reach of policy and programming decisions for food security. Governance structures and processes for surveillance systems will need to be highly coordinated across sectors to develop a shared understanding of the complex drivers of food insecurity in communities. Systems approaches have the potential to model complex problems and expand governance systems in ways that better addresses data needs and improves how data is collected and analyzed to inform policy and practice for complex social issues such as food insecurity. Objective and methods: Through a collaborative partnership with the British Columbia Centre for Disease Control, this project explored the practical application of systems thinking to governance systems of data and evidence that inform food security policy and practice. A knowledge synthesis approach was co-developed to develop guidance and best practices on the application of systems approaches and methods to food security surveillance. Initial discussions were held with key informants to understand governance gaps of food security surveillance systems in British Columbia. A broad evidence search was conducted to identify case study examples of applying systems approaches and methods to surveillance of any complex social or public health issue. Informed by these case study examples, dialogue sessions were conducted with knowledge users to gather their perspectives and experiences on the potential application of systems approaches and methods to food security surveillance systems in British Columbia. Findings from the evidence search and dialogue session were synthesized using thematic analysis. Results: The evidence search identified a range of systems approaches and methods that were applied to surveillance systems to either: (1) improve their overall structure and design; or (2) support modelling of a complex problem using surveillance data. Among knowledge users of food security data in British Columbia, these methods were viewed as an opportunity to improve cross-sectoral engagement across sectors and communities relevant to food security (e.g., health, agriculture, rural, underserved groups), provide an inclusive data approach to better understand interconnections of social and structural determinants of food security, and made complex data more accessible and understandable to diverse audiences. Potential barriers of implementing systems approaches to food security surveillance systems in British Columbia were also identified, including: data fragmentation, limited capacity and resources to support the sustainability of current surveillance systems, institutional knowledge and relationship losses due to role turnover, and poor collaborative mechanisms for cross-sectoral partnerships. Implications and significance: A systems-informed approach to governance that embeds data on the social and structural drivers of food security, alongside existing knowledge of economic determinants, will help to expand the current scope of food security policy and practice. For government and non-government organizations, this report shares practical guidance for assessing whether the strengths of systems approaches and methods can support their own surveillance activities. A decision aid is provided to guide organizations in selecting a systems method based on their needs related to food security surveillance. Future research is needed to examine the long-term impact of governance changes to surveillance systems that have been informed by systems approaches.